The difficulties in differential diagnosis of so-called "dark fundus lesions" are well known to all ophthalmologists. The following report concerns a most unusual example.
A 68-year-old white man had attacks of pain in the right eye, blurring of vision, and rainbows around lights, lasting between one-half to one hour and of inconstant frequency. He had had corneal foreign bodies removed, but there was no history of penetrating injury. Visual acuity was corrected to 20/50-1 OD and 20/20 OS. The intraocular pressure was 17.3 mm Hg (Schiotz) OD and 14.6 OS. Ophthalmoscopic examination through a widely dilated pupil and by various techniques showed an elevated pigmented lesion of the fundus just inferior and nasal to the disk. The possibility of a melanocytoma1 was considered, but the lesion appeared not to involve the nerve-head. It was about three disk diameters in size and protruded into the vitreous. The eye was enucleated
RONES B, ZIMMERMAN LE. An Unusual Choroidal Hemorrhage Simulating Malignant Melanoma. Arch Ophthalmol. 1963;70(1):30-32. doi:10.1001/archopht.1963.00960050032007